Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $4,265.80	Facility		$14.13	$14.13	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $11.48	Professional		$11.48	$11.48	$11.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $213.80	Facility		$100.00	$100.00	$213.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $218.78	Facility		$100.00	$100.00	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50